A Radiologic Classification of Hemophilic Arthropathy

Pettersson, Holger; Ahlberg, A; Im, Nilsson

doi:10.1097/00003086-198006000-00018

Cited by 511 publications

(507 citation statements)

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“…When evaluating HA based on X-ray studies, we shall keep in mind that the X-ray tends to underestimate severity of joint changes (11) . Indeed, in our study, the X-ray images showed the prevalence of early stages of Arnold and Hilgartner (3)' s HA, with low Petterson (4) scores. Nevertheless, the clinical examination was exuberant for all patients, indicating an overt inflammatory activity of the disease.…”

Section: Discussionsupporting

confidence: 53%

“…X-ray images of the knee showed subtle HA signs: osteopenia, epiphyseal enlargement and increased density of soft parts (Figure 2). This was an Arnold & Hilgartner (3) Phase II and the score of Petterson (4) scale was 2. Ultrasound test revealed a joint swelling, synovial thickening and enabled the identification of synovial villosities ( Figure 3).…”

Section: Cases Reportmentioning

confidence: 99%

“…HA is described as showing three consecutive phases: acute, sub acute and chronic (3) . HA's staging systems are based on X-ray findings (3,4) . In these cases, we intended to study the potential of an ultrasound test to study changes on soft parts.…”

Section: Introductionmentioning

confidence: 99%

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O ultra-som na artropatia hemofílica subaguda do joelho

Bellegard

Caetano

2006

Acta ortop. bras.

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São apresentados 4 casos de Artropatia Hemofílica Subaguda de Joelho em seus aspectos clínicos, radiográficos e ultra-sonográficos. A radiografia tem alterações discretas nas fases iniciais da Artropatia Hemofílica (AH). São enfatizados os aspectos do ultra-som, que proporcionou imagem direta da membrana sinovial no recesso capsular anterior do joelho. Discutimos a possibilidade de utilização da ultra-sonografia como marcador de atividade inflamatória.

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Section: Discussionsupporting

confidence: 53%

Section: Cases Reportmentioning

confidence: 99%

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O ultra-som na artropatia hemofílica subaguda do joelho

Bellegard

Caetano

2006

Acta ortop. bras.

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“…The mean age of the patients was 42 years of age (32-67), and the mean follow-up time was 132 months . Indication for total hip replacement was satisfied when two of the following five criteria were fulfilled: (1) Arthropathy stages IV or V [1], (2) rapid progress of the radiographic signs of joint destruction (Petterson-score >6) [18], (3) increasing contractures of the joint >15°(WFH-jointscore), (4) severe disabling pain, and (5) recurrent irritation of the joint with or without intraarticular bleeding. Although the knees of these patients showed radiological findings of haemarthrosis, the leading symptom was the pain in the hip.…”

Section: Methodsmentioning

confidence: 99%

Total hip replacement in patients with severe bleeding disorders

Habermann

Eberhardt

Hovy³

et al. 2006

International Orthopaedics (SICO

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Arthropathy of the hip is moderate in frequency in haemophiliac patients, but is less common than ankle, knee or elbow arthropathy. We report about our experience with total hip replacement in patients with severe bleeding disorders over a period of 30 years. Between July 1972 and 2002, 15 hips in 13 patients were replaced. The main bleeding disorders were Haemophilia A in ten patients and severe v. Willebrand disease in three patients. The mean follow-up was 132 months (range 12-363). We can demonstrate good long-term results, with only one aseptic loosening after 14 years and one septic loosening after 14 months in an HIV-positive patient. The Harris Hip Score increased from 48 points (32-66) preoperatively to 89 (76-100) postoperatively. In conclusion, total hip replacement performed in a specialised haemophiliac centre is a safe procedure, and results in pain relief and improvement of the quality of life in patients with severe bleeding disorders.

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“…Nevertheless, this imaging modality is only able to diagnose late arthropathic changes, most notably subchondral and bony abnormalities. While the World Federation of Hemophilia Pettersson X-ray scale [13] does not contain an item to represent soft tissue changes, the Arnold-Hilgartner X-ray scale [14] grades soft tissue and osteochondral changes subjectively on a 0-5 grading system. Pathological changes such as synovial hypertrophy, joint effusion, hemosiderin deposits and periarticular oedema can appear as nonspecific soft tissue swelling on radiography.…”

Section: Radiographymentioning

confidence: 99%

State‐of‐the‐art imaging techniques for the evaluation of haemophilic arthropathy: present and future

Doria

2010

Haemophilia

102

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Summary. In spite of the fact that the diagnosis of haemophilia is essentially clinical and laboratorybased, imaging has become an important tool for the evaluation of complications, diagnostic confirmation and/or complementation and therapeutic follow-up in haemophilic arthropathy. Radiography remains the workforce horse in the diagnosis and follow-up of haemophilic arthropathy. The radiographical findings in arthropathy follow an expected sequence of events and are overall similar in different joints. Magnetic resonance imaging (MRI) has advantages over radiography based on its capability of visualizing soft tissue and cartilage changes in haemophilic joints. The recent development and standardization of MRI scoring systems for measuring soft tissue and cartilage abnormalities may enable the comparison of pathological joint findings in clinical trials conducted at different institutions across the world. The implementation of high-frequency transducers and colour/power Doppler capabilities has provided new insights for clinical applications of ultrasonography (US) in haemophilic arthropathy. In spite of the imaging modality's technical challenges such as operator-dependency, US has advantages over MRI. One of these advantages is its ability of differentiating synovium hypertrophy and hemosiderin deposition, which is not possible with MRI given the presence of susceptibility artefacts from extracellular hemosiderin on gradient-echo MR images. In addition to the aforementioned conventional imaging modalities, novel imaging techniques (blood oxygen level dependent, ultrasmall superparamagnetic ironoxide contrast-enhanced, and T1 and T2 mapping MRI, ultrasound biomicroscopy, microbubble contrast-enhanced US and positron emission tomography, among others) hold promise for early assessment of haemophilic arthropathy in the future upon completion of their clinical validation.

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A Radiologic Classification of Hemophilic Arthropathy

Cited by 511 publications

References 0 publications

O ultra-som na artropatia hemofílica subaguda do joelho

O ultra-som na artropatia hemofílica subaguda do joelho

Total hip replacement in patients with severe bleeding disorders

State‐of‐the‐art imaging techniques for the evaluation of haemophilic arthropathy: present and future

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